Centorrino F, Baldessarini R J, Flood J G, Kando J C, Frankenburg F R
Department of Psychiatry, Harvard Medical School, Boston, MA.
Am J Psychiatry. 1995 Apr;152(4):610-2. doi: 10.1176/ajp.152.4.610.
This study was done to test the hypothesis that serum concentration of norclozapine is a risk factor for leukopenia during treatment with clozapine.
Maximum decreases in leukocyte counts in 44 unselected patients treated with clozapine were determined and then correlated with drug doses and serum concentrations of clozapine, norclozapine, and clozapine-N-oxide.
White cell and granulocyte counts decreased by up to 60%-73%, but there were no positive correlations between these decrements and drug dose, drug level, ratio of drug level to drug dose, or ratio of norclozapine level to clozapine level, nor were the decreases related to age or gender.
While these results do not suggest in vivo hemotoxicity of norclozapine, further study of patients with clinically significant leukopenia is required.
本研究旨在检验以下假设，即氯氮平治疗期间去甲氯氮平的血清浓度是白细胞减少的一个危险因素。
测定了44例未经挑选的接受氯氮平治疗患者白细胞计数的最大降幅，然后将其与药物剂量以及氯氮平、去甲氯氮平和氯氮平 - N - 氧化物的血清浓度进行关联分析。
白细胞和粒细胞计数下降高达60% - 73%，但这些降幅与药物剂量、药物水平、药物水平与药物剂量的比值或去甲氯氮平水平与氯氮平水平的比值之间均无正相关，且这些下降与年龄或性别无关。
虽然这些结果并未提示去甲氯氮平在体内具有血液毒性，但仍需要对临床上有显著白细胞减少的患者进行进一步研究。
